Q:

A 46 year old man is being treated for a pleural effusion. A chest drain has been sited just below the 4th rib in the mid-axillary line on his right side. What single structure is at particular risk of injury?

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A 46 year old man is being treated for a pleural effusion. A chest drain has been sited just below the 4th rib in the mid-axillary line on his right side. What single structure is at particular risk of injury?


  1. Arzygos vein
  2. Diaphragm
  3. Intercostal artery
  4. Internal thoracic artery
  5. Liver

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The key is C. Intercostal artery. [Most vulnerable structure is intercostal nerve, then intercostal artery then intercostals vein. As intercostal nerve is not in option intercostal artery is the answer here].

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